| NPI | 1821060872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: CO DR.0059476) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA MD072305L) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2018-12-17 |